Individual
KATELYNN PREWITT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
3026 POPLAR LEVEL RD, LOUISVILLE, KY 40217-1301
(502) 636-4929
(502) 394-3629
Mailing address
PO BOX 776879, CHICAGO, IL 60677-6879
(502) 588-9490
(502) 272-5116
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
3015793
KY
363LF0000X
Family Nurse Practitioner
71014235A
IN
363LP0200X
Pediatric Nurse Practitioner
3015793
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300080157
—
IN
05
—
7100733330
—
KY
01
—
K0003824
MEDICARE
KY
Enumeration date
02/02/2021
Last updated
11/08/2023
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